What is Endocarditis?

By Dr Ananya Mandal, MD

Endocarditis is an infection of the heart that can be fatal if left untreated. In this condition, the inner lining of the heart or endocardium becomes infected, usually by bacteria that enter the bloodstream and get carried towards the heart.

Normally, the heart is protected against infection and most bacteria can pass through without causing infection. However, the risk of infection rises in the presence of disorders such as damaged heart valves, in which case it is easier for the bacteria to establish themselves and avoid the usual immune process that eliminates them.

Symptoms

Some of the initial endocarditis symptoms are flu-like and include fever (temperature at or above 38C), joint and muscle pain and headache. If the infection is not treated, it can damage the heart valves and disrupt the normal flow of blood in the heart. This may lead to complications such as heart failure, where the heart fails to pump blood into the circulation. Stroke is another complication, where blood flow to the brain is disrupted.

Risk factors and causes

Some of the risk factors for developing endocarditis include having an artificial or prosthetic heart valve, congenital heart disease and damaged heart valves. Heroin users are also at a much higher risk of developing the condition compared with the rest of the population.

Diagnosis and treatment

Diagnosis is based on a patient’s symptoms, medical history and a physical examination. The doctor may use a stethoscope to check for signs of endocarditis such as a heart murmur. Some of the tests that may be arranged in order to check for the condition include blood tests, electrocardiography (ECG), X-ray and magnetic resonance imaging (MRI).

The aim of treatment is to eliminate the bacteria. The patient is administered antibiotics intravenously while in hospital. Around one fifth of those treated for endocarditis will also require surgery to repair heart valves or to drain an abscess. Even when the standards of health care are very high, the risk of death from endocarditis is about 20%. Early detection and prompt treatment are therefore essential to increase the likelihood of survival.

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